Provider Demographics
NPI:1437188745
Name:SOLOMON, JENNIFER L (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 EAST 70TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4823
Mailing Address - Country:US
Mailing Address - Phone:212-606-1720
Mailing Address - Fax:212-327-1417
Practice Address - Street 1:523 EAST 72ND STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4099
Practice Address - Country:US
Practice Address - Phone:212-606-1720
Practice Address - Fax:212-327-1417
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2196091208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0588J1Medicare ID - Type UnspecifiedMEDICARE NUMBER
NYI02648Medicare UPIN
NY0588J1Medicare PIN
NYA400002793Medicare PIN